Management after acute rupture of the anterior cruciate ligament (ACL). Part 1: ACL reconstruction has a protective effect on secondary meniscus and cartilage lesions

被引:16
作者
Petersen, Wolf [1 ]
Guenther, Daniel [2 ]
Imhoff, Andreas B. [3 ]
Herbort, Mirco [4 ]
Stein, Thomas [5 ,6 ]
Schoepp, Christian [7 ]
Akoto, Ralph [8 ]
Hoeher, Juergen [9 ]
Scheffler, Sven [10 ]
Stoehr, Amelie [4 ]
Stoffels, Thomas [11 ]
Haener, Martin [1 ]
Hees, Tilman [1 ]
Mehl, Julian [3 ]
Ellermann, Andree [12 ]
Krause, Matthias [13 ]
Mengis, Natalie [12 ]
Eberle, Christian [12 ]
Mueller, Peter E. [14 ]
Best, Raymond [15 ,16 ]
Lutz, Patricia M. [3 ]
Achtnich, Andrea [3 ]
机构
[1] Martin Luther Hosp, Dept Orthoped, Sportsclin Berlin, Caspar Theyss Str 27-31, D-14193 Berlin, Germany
[2] Witten Herdecke Univ, Cologne Merheim Med Ctr, Dept Orthopaed Surg Trauma Surg & Sports Med, Ostmerheimer Str 200, D-51109 Cologne, Germany
[3] Tech Univ Munich, Dept Orthoped Sports Med, Ismaninger Str 22, D-81675 Munich, Germany
[4] OCM Clin Munich, Steinerstr 6, D-81369 Munich, Germany
[5] SPORTHOLOGICUM Frankfurt Main, Siesmayerstr 44, D-60323 Frankfurt, Germany
[6] Goethe Univ Frankfurt, Dept Sports Med, Ginnheimer Landstr 39, D-60487 Frankfurt, Germany
[7] Duisburg gGmbH, Dept Arthroscop Surg Sports Traumatol & Sports Me, BG Klinikum, Grossenbaumer Allee 250, D-47249 Duisburg, Germany
[8] BG Hosp Hamburg, Dept Trauma & Orthopaed Surg, Sports Traumatol, Hamburg, Germany
[9] SPORTSCLIN COLOGNE, Ostmerheimer Str 200, D-51109 Cologne, Germany
[10] Sporthopaedicum Berlin, Bismarckstr 45-47, D-10627 Berlin, Germany
[11] OC Stadtmitte, Friedrichstr 63, D-10117 Berlin, Germany
[12] ARCUS Sports Clin, Rastatter Str 17-19, D-75179 Pforzheim, Germany
[13] Univ Med Ctr Hamburg Eppendorf, Dept Trauma & Orthopaed Surg, Martinistr 52, D-20246 Hamburg, Germany
[14] Ludwig Maximilians Univ Munchen, Univ Hosp, Dept Orthopaed & Trauma Surg, Musculoskeletal Univ Ctr Munich MUM, Marchioninistr 15, D-81377 Munich, Germany
[15] Sportklin Stuttgart, Dept Orthopaed & Sports Trauma Surg, Taubenheimstr 8, D-70372 Stuttgart, Germany
[16] Univ Tubingen, Dept Sports Med & Orthopaed, Hoppe Seyler Str 5, D-72074 Tubingen, Germany
关键词
Osteoarthritis; Meniscus; Cartilage; ACL; Consensus; Algorithm; KNEE OSTEOARTHRITIS; TIBIAL TRANSLATION; INJURY; CONSENSUS; RISK;
D O I
10.1007/s00167-022-06960-1
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose The aim of this consensus project was to validate which endogenous and exogenous factors contribute to the development of post-traumatic osteoarthritis and to what extent ACL (anterior cruciate ligament) reconstruction can prevent secondary damage to the knee joint. Based on these findings, an algorithm for the management after ACL rupture should be established. Methods The consensus project was initiated by the Ligament Injuries Committee of the German Knee Society (Deutsche Kniegesellschaft, DKG). A modified Delphi process was used to answer scientific questions. This process was based on key topic complexes previously formed during an initial face-to-face meeting of the steering group with the expert group. For each key topic, a comprehensive review of available literature was performed by the steering group. The results of the literature review were sent to the rating group with the option to give anonymous comments until a final consensus voting was performed. Consensus was defined a-priori as eighty percent agreement. Results Of the 17 final statements, 15 achieved consensus, and 2 have not reached consensus. Results of the consensus were summarized in an algorithm for the management after ACL rupture (infographic/Fig. 2). Conclusion This consensus process has shown that the development of post-traumatic osteoarthritis is a complex multifactorial process. Exogenous (primary and secondary meniscus lesions) and endogenous factors (varus deformity) play a decisive role. Due to the complex interplay of these factors, an ACL reconstruction cannot always halt post-traumatic osteoarthritis of the knee. However, there is evidence that ACL reconstruction can prevent secondary joint damage such as meniscus lesions and that the success of meniscus repair is higher with simultaneous ACL reconstruction. Therefore, we recommend ACL reconstruction in case of a combined injury of the ACL and a meniscus lesion which is suitable for repair.
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收藏
页码:1665 / 1674
页数:10
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